Are your benefits working for you? Navigating the world of group benefits can be confusing at times. For many who have benefits through their employment, they may not be aware of everything that entails. Belmont has put together a few of the most common benefits that are part of many benefits packages. For specific information regarding your benefits, contact Belmont and speak to one of our qualified advisors, or get a second opinion from us!
STUDENT ELIGIBLILITY
Many plans cover dependent children up to the age of 21 (or 25, if attending full time post-secondary education). After the age of 21, your Plan Sponsor would need proof each year before September. Please check your employee booklet for dependent eligibility.
CO-ORDINATION OF BENEFITS
Families with two working adults may be covered by more than one health or dental plan. If your primary plan doesn't pay the full amount of an expense, you can submit a claim to the other plan for the balance. In this way, you can receive up to 100% of your expense. Please check with your Plan Sponsor on the rules for Co-ordination of Benefits.
GROUP TRAVEL INSURANCE
Your Group Travel covers certain emergency medical expenses incurred when you and your dependents are travelling outside your province of residence, however, most Group Travel Insurance includes a “Pre-existing Condition” clause, which relates to a specified number of days an existing condition must be “stable” prior to travel. Coverage might not be eligible, unless deemed “stable” according to the contract definition prior to your travel date.
Some Group Benefits contracts “stability” clause is 60, 90, 120, 180 days (or longer). Please check with your Plan Sponsor before travelling to see what your Travel Insurance covers.
LIFE INSURANCE
Who you designate as beneficiary is very important! Remember to update your beneficiary when you have life-changes such as marriage, birth, divorce, death.
A BENEFICIARY is the legal entity who is eligible to receive the case benefit from your policy when you die.
Taxability: Life Insurance proceeds are not taxable in the hands of the beneficiary when a person is named as beneficiary. However, if you named an estate as beneficiary, the proceeds may be subject to estate administration taxes or probate fees.
Beneficiary: Employees may want to list a contingent beneficiary when considering whom to designate as
beneficiary for group life insurance. A contingent beneficiary would receive the funds only if the first named
primary beneficiary dies before the insured person.
Dependent Children as beneficiary: When an employee has underage dependent children named as
beneficiary, it is a good idea to name a trustee to receive and distribute proceeds for the children. The
employee may also want to consider having a lawyer draw up a legal trust agreement to ensure that
insurance proceeds are used as intended.
Do you have a will? If you have a will, please be sure your documents are consistent.
LATE APPLICANTS
When a new employee enrolls in the group benefits plan, they may opt out of health and dental if they have
benefits through a spouse. If the employer later loses spousal benefits, he/she has 31 days to enroll in your
plan. If the employee does not enroll in the plan within that time, they would be considered a late applicant.
Late applicants must have health evidence approved prior to being enrolled in the health plan. For late
applicants, dental coverage is restricted for the first 12 months.
PLAN ADMINISTRATORS / BILLING CHANGES
It is important to review your billing for member changes, new employees, and terminated employees. Don’t
delay in sending new enrollments, changes, salary increases.
The Importance of Correctly Reporting Salaries
Death benefit payments and disability benefit payments are typically based on plan members’ salaries. It is
important that members’ salaries are accurately reported on a regular basis, otherwise their benefit
payments will not be based on the correct salary.
As plan administrator, you have the responsibility of providing salaries according to the definition of salary
stipulated under your contract and maintaining accurate and current information for all of your plan
members administered by Belmont Health & Wealth. We must be made aware of any salary changes as soon
as possible. Failure to properly report salary increases/decreases will result in benefit payments to your plan
members being incorrect.